OUR BABIES.

Rangitikei Advocate and Manawatu Argus, Volume XLI, Issue 11700, 21 October 1916, Page 6

OUR BABIES.

Published under the auspices of the Society for the Health of Women and Children.

LETTER FROM A NURSE. There is a baby under my care whom I cannot get to thrive satisfactorily. Her mother is worrying about her, and would be pleased to hear what you advise. She is a breast-fed baby, nearly five and ahalf months old, fed regularly, plenty of fresh air, and in every way treated on the Society’s lines. The doctor has examined her thoroughly, and found she has a defective heart; but he says it should not in any way prevent her from thriving. The child will not drink much, although there is plenty of milk in the breast; nor will she take it from the bottle. When baby was three months old she was weighed before and after every nursing for a period of 34 hours, 'and it was fount! that she took 24>£oz for the full day’s amount. The' mother’s milk was tested, and the fat percentage was 4. The mother was dieted, and the baby was given %oz of water before feedings; but the only difference seamed to be an increased frequency of motions, which have always been very frequent, although quite yellow'. Then (with the doctor’s permission) we tried giving her loz of boiled Humanised Milk before the ! breast, but she did not thrive any better on this experiment. This week I got the mother’s milk tested again, and there \yas 3.6 per cent, of fat. The baby is perfectly good and happy. I am enclosing a copy of the weight chart. Trusting this is plain, and that you will not think it foolish inquiring.—l am,etc.

REPLY. Regarding the baby you write about, I not only don’t think it foolish your inquiring, but! decided|y appreciate the trouble yon have taken in describing the case and your anixety to get any hint that might lead to a more satisfactory rate of growth. Of course, the progress has been extremely slow; but one favourable point is that the increase in weight has been sustained and regular. You must bear in mind that sometimes a baby who appears to be normal cannot be got to put on weight at the average rate, though generally, if no pains are spared, the slow progress ultimately gives way to a normal rate of growth. However, you are quite right to be anxious, especially when for five months the average increase has been less than half the normal. This prolonged retardation calls for the most serious consideration, and no stone should be left unturned to promote greater activity of digestion and nutrition.

You do not mention anything as to the relative states of growth (increase in length, etc ) and the stored reserves of fat. Has the baby continued to grow in bone, muscle, etc., but become thinner and thinner? I should suppose that by this time she is more or less emaciated, or, at best, iWhat would be called poorly nourished. One always ought to bear in mind that the results of under-feed-ing and the consequent storage of a deficiency of fat in the system are generally less serious than the results of prolonged over-feeding. As Prof°ssor Buid eo often remarked: Overfed babies suffer from indigestion, and it is often very difficult to cure this. In underfed babies, on the other hand, digestion, commonly remains comparatively unimpaired, and they tend to go ahead quickly and do their best to make up for'lost time when we get them to take the proper amount of food. This applies not only to cases where the baby has been allowed less than it would have taken, but also to cases were the food supply has been ample—the appetite or inclination for food falling short of the normal.

From what yon say, it appears most probable that, in the present case, the baby’s appetite has been wanting, while the mother’s milk sapply has been “sufficient, though there may be some doubt on the point. Wo have sometimes found that where the conclusion had been arrived at that the store ot mother’s milk available was ample, this was not really the case. It might be that, after the baby had suckled, a few drops could be squeezed out readily, but still the breasts were almost empty, and the child had ceased sucking because it had been overlong at the breast and the flow was not satisfying. 1 Whatever may be the defect in the present case you may take it for granted that some improvement may be brougnt about?— 1. By doing possible to improve tha quantity and quality of the mother’s milk supplj', Ample daily open-air exercise, bathing, fresh air day and night, proper attention to food and feeding habits, the ensuring of good digestion and tiie avoidance of constipation, the taking of a sufficiency of fluid, stimulation of the breasts by local bathing or massage (if need), giving baby both breasts at each suckling, bst starting with the right breast at one nursing and the left “at the next —due attention to all these points (which are fully emphasised in the Society’s book) can be relied on to achieve a great deal in the way of improving the quality of the milk quite apart from the question of quantity. 2. Incases of babies presenting the features you describe, I have found a wonderful improvement to follow on stimulating the child by paying great attention to everything promoting vigorous health on the lines set forth on pages 1 and 2 of “Feeding and Care of Baby.” It must never be forgotten that perfectly normal babies tend to become lazy, indolent, dispirited, and flabby, and to dwindle away if they are allowed to lead too passive an existence, and that this may happen either to sucklings or to bottlefeds, in spite uf the fact that the food supply is ample and of good quality. “Mothering” and “Management” as referred to on page 2, are matters of supreme importance, and I have found that one can enlist the mother on our side by pointing out the need for proper daily exeibiee and stimulation, and by explaining to her that even when at the breast the baby ought to be kept active and alert. Thus one cun get the mother to pay proper attention to such details as handling, lingering, and rubbing the baby’s hands, feet, and limbs, when it seems inclined to drop off to sleep while at the breast.

Nothing tends to promote good I digestion and proper nutrition and 1 growth more than kicking exercise several times a day . without too much clothing on, preceded and followed by a little massage. Working on such lines,l have known babies who have failed to pat on weight for months to start almost straight away, gaining at more than the average rate every week, so that in the course of a few mouths they have caught up the normal. Regarding weighing before and aficr nursing, you should not rely on a single day’s weighing hut have the weighings done for several successive days to make sure you ascertain the true average intake. I don’t qnite understand your object in recommending the of water before feeding, because that would tend to diminish the inclination and appetite for breast-milk instead of promoting it. If the mother’s health and the baby’s health were both improved and toned up, most likely the normal frequency of motions would soon be established.